UK health authorities recently announced they hope to prevent all new cases of HIV in England and officially make the country the first country in the world to “beat the virus” by 2030. They say they will achieve this through a series of new deals which they closed. with pharmaceutical companies to ensure availability of effective new drugs across the country. This is undoubtedly good news for the people of England. Nevertheless, as we have realized since the start of the COVID-19 pandemic, no country can single-handedly “beat” a virus. Viruses know no borders. The way to end a pandemic is not through local pharmaceutical companies, but through global solidarity.
Today, beating HIV worldwide is indeed within reach thanks to miraculous new medicines and treatments already on the market and in development – but only if we work together and ensure that the most effective preventive medicines and treatments are available to everyone in the world. emergency anywhere in the world.
The new drug that England hopes will help it ‘beat’ HIV for good in less than a decade is the long-acting injectable form of the established HIV drug cabotegravir. The drug is not only a great treatment for people who are HIV positive, but it is also very effective as a preventative treatment. In July 2022, the World Health Organization published its guidelines for the use of long-acting injectable cabotegravir (CAB-LA) as pre-exposure prophylaxis (PrEP) for HIV and called for “countries to consider this safe and highly effective prevention option for HIV.” people at significant risk of HIV infection”.
This drug is seen as a potential game changer in the fight against HIV, mainly because it offers sufficient protection through bimonthly injections. According to the WHO, the first randomized trials showed that “the use of CAB-LA resulted in a 79 percent relative reduction in HIV risk compared to oral PrEP, where it was often challenging to take daily oral medications” .
Everything indicates that CAB-LA has the potential to help us finally confine AIDS to the dustbin of history. However, the battle to deliver this miraculous medicine to all who need it has only just begun. This most effective form of HIV prevention is still out of reach for those most at risk of contracting HIV.
Put profit before life
CAB-LA is patented and manufactured by ViiV Healthcare, an offshoot of the pharmaceutical companies Pfizer, GlaxoSmithKline, and Shionogi. Like all pharmaceutical companies, ViiV Healthcare is profit-oriented.
This is why it has not yet made CAB-LA available all over the world at an affordable price.
Initially, the company blocked the production of generic, low-cost CAB-LA anywhere in the world by refusing to issue voluntary licenses to generic drug manufacturers in developing countries, citing “the complexities of manufacturing, regulatory requirements, capital investment needs and unpredictable demand”.
After much resistance from civil society organizations, activists and health institutions, the company turned around and in July 2022 reached an agreement with the UN-backed Medicines Patent Pool to access the generic formulation of CAB-LA up to 90 low and lower to middle-income countries.
News of the voluntary license agreement was widely celebrated, but even this commitment did not immediately give all those in need access to this critical HIV drug. It is expected to take four to five years for generic drug manufacturers to develop CAB-LA, scale production, perform all necessary testing and submit registration. This means that affordable CAB-LA will not be available in most countries for years to come and it will still be up to ViiV Healthcare to supply the drug to all markets.
ViiV has a clear policy of supplying its medicines to low-income developing countries, including countries with very high HIV incidence in sub-Saharan Africa, “at cost”. However, the company has not yet officially announced what that price would be for CAB-LA. Doctors Without Borders says ViiV informed them in July 2022 that the non-profit price is $210-$240 per person per year and “is subject to change at any time.”
This number is more than 10 times what the Clinton Health Access Initiative (CHAI) estimates a generic price for CAB-LA could be: less than $20 per year. These delays in making the breakthrough injection available in countries that need it most will result in thousands of new HIV infections that could and should have been prevented.
Unfortunately, ViiV Healthcare’s actions are not uncommon. Since the very beginning of the HIV epidemic, pharmaceutical giants like ViiV have slowed down the South’s access to breakthrough drugs to protect their profit margins. In the 1990s, when most countries in southern Africa were devastated by AIDS and death rates from the virus far exceeded birth rates in many communities, for example, the Pharmaceutical Research and Manufacturers of America, an alliance of the 100 largest Drug companies in the US aggressively lobbied against an attempt by South Africa to manufacture and deliver generic AIDS drugs to patients at a fraction of the price charged by US patent holders. Their lobbying and ensuing legal warfare significantly hampered South Africa’s efforts to contain the virus and led to numerous preventable deaths.
We cannot allow this sad history to repeat itself. With CAB-LA, we finally have a weapon strong enough to defeat HIV for good – not just in England, but around the world. But if we are serious about ending transmissions, we need to make sure that everyone who is at high risk of contracting HIV, including those in Africa, has access to this drug at an affordable price, not in a decade or a year. a few years. but now.
The views expressed in this article are those of the author and do not necessarily reflect the editorial view of Al Jazeera.